Date: February 8, 2022Attorney: Donald A. Dennison

In New Jersey, Medicaid, specifically, New Jersey Family Care, is an umbrella term that encompasses various Medicaid programs designed to accommodate people with different asset and/or income circumstances. The one common thread that binds all Medicaid programs together, however, is that no matter the program, Medicaid is a form of means-tested benefits. In other words, in order to obtain Medicaid coverage under one of New Jersey’s various Medicaid programs, an applicant’s income and/or assets (resources) are measured against certain federal poverty guidelines that are modified from year to year based on the cost-of-living adjustment (COLA).

One such Medicaid program, NJ Workability, is a program designed to accommodate New Jersey residents who have a permanent disability (as determined by the Social Security Administration) and who were previously required to meet the following eligibility criteria:

(1) Aged sixteen (16) through sixty-four (64);

(2) Employed;

(3) Receive earned income equal to or less than $5,433 per month for an individual, or $7,325 per month for a couple – both of whom need to be disabled and employed (250% of the federal poverty level);

(4) Receive unearned income equal to or less than $1,074 per month for an individual and $1,452 per month for a couple – both of whom need to be disabled and employed; and

(5) Have liquid assets less than $20,000 for an individual and $30,000 for a couple.

As you can see from the previous eligibility guidelines above, NJ Workability had both income and resource (asset) eligibility requirements, however, in December 2021, bill S-3455 was unanimously passed by the NJ State Senate by a 36-0 vote and subsequently signed into law on January 10, 2022. Under the NJ Workability expansion, the following eligibility criteria have been revised or otherwise abolished entirely:

(1) Removing the upper age limit of sixty-four (64), provided the applicant would otherwise meet eligibility criteria;

(2) Premium contributions for an individual beneficiary will now be based solely on that beneficiary’s earned and unearned income, and the income (either earned or unearned) of the beneficiary’s spouse will not be deemed to the beneficiary/Workability applicant;

(3) Abolishing the income limit entirely (emphasis added); and

(4) Permitting a NJ Workability beneficiary to remain “eligible” for the program for up to one (1) year if, through no fault of her own, a loss of employment occurs.

This drastic expansion of the NJ Workability program encourages individuals who can work with a permanent disability to do just that without fear of disqualifying him/herself from Medicaid benefits due to income received in excess of the previous monthly income cap. Additionally, the expansion of the NJ Workability program will open the doors of eligibility for thousands of New Jersey residents who otherwise qualify for the program, but who are sixty-five (65) years old or older. If you or a loved one have questions about the change in NJ Workability’s eligibility requirements or other Medicaid programs offered under the umbrella of NJ Family Care, the Elder and Disability Law team at Mandelbaum Barrett PC invites you to schedule an appointment with us to discuss these issues and more.